Basic Information
| Provider Information | |||||||||
| NPI: | 1457736142 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC. | ||||||||
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| OtherOrganizationName: | JOHNS HOPKINS ALL CHILDREN'S EARLY STEPS THERAPY SERVICES | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 5TH ST S DEPT 6941 | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337014804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277674429 | ||||||||
| FaxNumber: | 7277674970 | ||||||||
| Practice Location | |||||||||
| Address1: | 480 7TH AVE S | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337014839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277674403 | ||||||||
| FaxNumber: | 7277676721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2015 | ||||||||
| LastUpdateDate: | 05/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | SCHULHOF | ||||||||
| AuthorizedOfficialFirstName: | KRISTY | ||||||||
| AuthorizedOfficialMiddleName: | ALICIA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7278987451 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | 231H00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist | 235Z00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 2251P0200X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 064636900 | 05 | FL | MEDICAID | 010151603 | 05 | FL | MEDICAID |